‘Unreserved’ apology as damning report criticises killer’s care

A breakdown in communication between healthcare and prison staff led to a paranoid schizophrenic being released from a secure hospital without any support, a report has found.

Leyton Williams went on to savagely attack his own mother Queenie before slashing his friend Anthony Kitely to death with a shard of glass.

In a damning report released this afternoon, Healthcare Inspectorate Wales (HIW) admitted serious failings in Mr Williams’ support after he was admitted to HMP Parc Prison, near Bridgend, in 2008.

Health, prison, council and probation bosses have made an ‘unreserved’ apology and confirmed that action has been taken to address the circumstances that led to Mr Williams’ attacks.

As well as making 15 recommendations, the report highlighted concerns in relation to the adequacy of the care and treatment provided to Mr Williams, including:

* Following his recall to prison in July 2008, there was a lack of a “concerted effort” by health and social care agencies to identify which prison he had been admitted to so that his mental health could be monitored.

* When he was admitted to prison, opportunities were missed to refer him back to mental health services.

* Neither the Caswell Clinic nor Parc Prison were invited to MAPPA meetings held to discuss Mr Williams’ care and circumstances, which led to a lack of understanding of his healthcare needs and the risk presented by him.

* A breakdown in communication between all agencies meant that when Mr Williams was released from prison in September 2008 he was not in receipt of care, treatment or supervision from any statutory agency.

* Despite police raising concerns about his mental health following calls to his family home, further opportunities to re-engage with Mr Williams were missed by mental health services.

At his trial in June last year Mr Williams admitted the manslaughter of his friend Mr Kitely, on the grounds of diminished responsibility, and the assault on his mother, Queenie Williams.

Inquiry launched

Cardiff Crown Court heard how, in the absence of proper support and supervision, he became convinced Mr Kitely and his own family were out to get him.

Frightened by three voices in his head, a drunk Mr Williams savagely attacked his mother at the family home in Cairnmuir Road, Tremorfa, Cardiff, leaving her lying in a pool of blood in the kitchen.

The court was told how, after the assault on June 6 2009, he walked around the corner to Meirion Place, where he killed “popular and friendly” Mr Kitely, 37, a father of three.

The following day Mr Williams knocked on a door in Hilton Street, Splott, Cardiff, and told a woman who answered: “I feel ill… I think I’ve killed my mother.”

He said he wanted police called because he had done something bad. When officers arrived he told them he had also been to Mr Kitely’s home and the place was covered in blood.

Mr Williams was sentenced to be held in Ashworth Hospital indefinitely.

At the time, Mr Kitely’s mother Gale, of Cottrell Road, Roath, said: “The panel that released him virtually signed my son’s death warrant.

“Somebody somewhere has made a very big mistake and it cost the life of my son. Had Leyton not been released, Anthony would still be alive.”

Chief Executive of HIW, Dr Peter Higson, said: “It is clear from our review that Mr Williams had a history of violence and mental illness.

“He was difficult to engage with and consistently denied that he had mental health issues and was therefore unlikely to seek help when his mental health deteriorated.

“Sadly a breakdown in communication between statutory agencies meant that following his release from prison in September 2008 Mr Williams’s mental health issues went unmonitored.”

Mr Whitely’s family said today: “We welcome the publication of the report and its findings.

“After reading the report it has helped us to understand more about what led up to Anthony’s untimely death.

“We do not blame LW [Leyton Williams] for what happened, but the lack of a cohesive mental health care system, including the poor communication that lead to his release.

“This one decision damaged all of our lives irreparably and in many different ways, from health to emotional growth.

“We live with a huge sense of loss that Anthony has gone, and hope that the publication of this report will give us a sense of closure.

“We would appreciate our privacy being respected and will make no further statements.”

NHS Wales chief executive David Sissling said: “My thoughts are very much with the families of those affected by this serious and deeply distressing case.

“It is important that when such tragic events occur, we investigate thoroughly to identify any shortcomings in the care and put in place measures to reduce the risk of such incidents happening again.

“The Welsh Government therefore commissions an independent investigation following every homicide, if the perpetrator has been in contact with mental health services in Wales within the last 12 months.

“Such reviews may reveal failings in the level of service provided and, in this complex case, there were several key findings of concern. I will expect the local health boards involved to work together and, with other partners, to take the appropriate actions and learn from this tragic case.

“We will also consider whether actions might need to be addressed nationally.

“On behalf of the NHS in Wales, I would like to apologise sincerely to everyone affected by this tragedy.”

Dr Chris Jones, medical director of NHS Wales, said: “While risk can never be eliminated entirely, it is vital we do everything possible to reduce it”.

“These incidents are, thankfully, small in number and individuals with mental health problems are far more likely to harm themselves than others.

“Local organisations have action plans in place to address the recommendations in the report, and this will be followed up with them by the Welsh Government.”